Mammography Positioning Improvement Collaborative

American College of Radiology Mammography Positioning Improvement CollaborativeSuboptimal mammography positioning is the primary factor leading to technically inadequate mammograms. Poor mammogram quality contributes to undetected breast cancer. In a single-institution study, only 67% of images met the positioning criteria set forth by the American College of Radiology® (ACR®). (Pal et al., AJR 2018).

The Mammography Positioning Improvement Collaborative seeks to improve breast cancer detection through screening.

Improvement collaborative participation supports site teams with creating a standardized system for mammography positioning, evaluation and ongoing monitoring, with the goal of delivering images that more consistently meet the ACR positioning criteria. Please note, technical skill training on positioning is not a program component.

Problem Statement

Mammography positioning is variable and inconsistent, leading to possible missed diagnosis of a patient’s cancer.

How the Collaborative Works

Each collaborative site forms an interdisciplinary team of four to six members who participate in the ACR ImPower Program with shared learning alongside a cohort of colleagues from four to six institutions, identifying ways to improve the positioning of screening mammograms.

Suggested team members:

  • Radiologist with a breast imaging clinical focus.
  • Mammography supervisor or manager.
  • Mammography technologist.

How to participate

Leadership and Advisory Committee

Collaborative Leader


Advisory Committee 

Sarah Pittman, MDSarah Pittman, MD, Clinical Assistant Professor in the Department of Radiology, Stanford University School of Medicine
  • Stamatia Destounis MD, FACR, FSBI, FAIUM
  • Dana Smetherman, MD
  • Margaret Szabunio, MD, FACR, FAAWR
  • Patricia Cowart, RT
  • Louise Miller, RT

    ACR Learning Network Participating Organizations


    Cohort 1 Sites

    • ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, Newark, DE
    • MemorialCare Breast Center at Long Beach Memorial, Long Beach, CA
    • Stanford Health Care, Palo Alto, CA
    • Solis Mammography, Addison, TX
    • Cleveland Clinic, Cleveland, OH
    • Doris Kupferle Breast Center at Texas Health Harris Methodist Hospital, Fort Worth, TX

    Cohort 2 Sites

    • Duly Health and Care, Lisle, IL
    • Hewitt Center for Breast Wellness at Griffin Health, Derby, CT
    • Pennsylvania Hospital, Penn Medicine, Philadelphia, PA
    • University of New Mexico School of Medicine Department of Radiology, Albuquerque, NM
    • Woman's Hospital, Baton Rouge, LA
    • Solis HCA Houston Healthcare Clear Lake, Clear Lake TX
    • Solis HCA Houston Healthcare Southeast Pasadena, TX
    • Solis Houston Northwest, Houston, TX